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高压氧治疗计算机断层扫描(CT)引导下肺穿刺针标记并发空气栓塞

[Hyperbaric oxygen therapy for air embolism complicating computed tomography (CT)-guided needle marking of the lung].

作者信息

Mizutani Eiki, Nakahara Kazuki, Miyanaga Shigeki, Yoshiya Tomoharu

机构信息

Department of Thoracic Surgery, Tokyo Teishin Hospital, Tokyo, Japan.

出版信息

Kyobu Geka. 2012 Sep;65(10):899-902.

Abstract

Preoperative computed tomography( CT)-guided marking with a short hook wire for small sized lung tumors has become popular along with the spread of thoracoscopic surgery. Systemic arterial air embolism is a very rare but potentially fatal complication. The patient was a 79-year-old man who was found to have a mixed ground glass opacity shadow on chest CT. Almost immediately after marking, he lost consciousness and complete atrio-ventricular (AV) block was found on the electrocardiogram (ECG) monitor. Brain CT showed intravascular air bubbles in the right frontal lobe. Two hours later, his conscious level was recovered completely but remained left hemiplegia. Five hours later, he was transported to another hospital for hyperbaric oxygen therapy. After 3 episodes of the treatment, left hemiplegia recovered with slight sense disorder in the left little finger. When neurologic findings are remained after air embolism, hyperbaric oxygen therapy should be arranged immediately.

摘要

随着胸腔镜手术的普及,术前使用短钩丝在计算机断层扫描(CT)引导下对小型肺肿瘤进行标记已变得很常见。系统性动脉空气栓塞是一种非常罕见但可能致命的并发症。该患者为一名79岁男性,胸部CT发现有混合性磨玻璃密度影。标记后几乎立即,他失去意识,心电图(ECG)监测发现完全性房室(AV)传导阻滞。脑部CT显示右额叶有血管内气泡。两小时后,他的意识水平完全恢复,但仍遗留左侧偏瘫。五小时后,他被转至另一家医院接受高压氧治疗。经过3个疗程的治疗,左侧偏瘫恢复,仅左手小指有轻微感觉障碍。空气栓塞后若仍有神经学表现,应立即安排高压氧治疗。

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